关键词： Human Genetics   Molecular Medicine   Gene Function   Metabolic Diseases  

摘要： Genetic defects of innate immunity impairing intestinal bacterial sensing are linked to the development of Inflammatory Bowel Disease (IBD). Although much evidence supports a role of the intestinal virome in gut homeostasis, most studies focus on intestinal viral composition rather than on host intestinal viral sensitivity. To demonstrate the association between the development of Very Early Onset IBD (VEOIBD) and variants in the IFIH1 gene which encodes MDA5, a key cytosolic sensor for viral nucleic acids. Whole exome sequencing (WES) was performed in two independent cohorts of children with VEOIBD enrolled in Italy (n = 18) and USA (n = 24). Luciferase reporter assays were employed to assess MDA5 activity. An enrichment analysis was performed on IFIH1 comparing 42 VEOIBD probands with 1527 unrelated individuals without gastrointestinal or immunological issues. We identified rare, likely loss-of-function (LoF), IFIH1 variants in eight patients with VEOIBD from a combined cohort of 42 children. One subject, carrying a homozygous truncating variant resulting in complete LoF, experienced neonatal-onset, pan-gastrointestinal, IBD-like enteropathy plus multiple infectious episodes. The remaining seven subjects, affected by VEOIBD without immunodeficiency, were carriers of one LoF variant in IFIH1. Among these, two patients also carried a second hypomorphic variant, with partial function apparent when MDA5 was weakly stimulated. Furthermore, IFIH1 variants were significantly enriched in children with VEOIBD as compared to controls (p = 0.007). Complete and partial MDA5 deficiency is associated with VEOIBD with variable penetrance and expressivity, suggesting a role for impaired intestinal viral sensing in IBD pathogenesis.

关键词： Inflammatory bowel disease   Sexual dysfunction   Prevalence   Risk factors   Meta-analysis  

摘要： Purpose Sexual dysfunction (SD) is increasingly identified in patients with inflammatory bowel disease (IBD), but there are few systematic reviews and meta-analyses of the studies of SD in IBD patients. The purpose of the study is to further quantify the association between IBD and SD. Methods MEDLINE (OVID), EMBASE (OVID), and the Cochrane Library (OVID) were searched (until August 2020) to identify observational studies that reported the prevalence and risk factors of SD in IBD patients. Pooled prevalence, odds ratios (ORs), and 95% confidence intervals (95% CIs) were calculated. Results Of the 945 citations evaluated, 18 studies (including 36,676 subjects) reporting the prevalence of SD in the IBD population were included for analysis. The overall pooled prevalence was 39% (95% CI 37-40%, P < 0.001). The prevalence of SD in women was 53% (95% CI 50-55%, P < 0.001), and it was 27% (95% CI 25-29%, P < 0.001) in men. The prevalence was higher in conjunction with operation (OR, 1.33, 95% CI 1.22-1.45, P < 0.001), depression (OR 6.14, 95% CI 3.51-10.76, P < 0.001), disease activity (OR 2.73, 95% CI 1.32-5.64, P = 0.007), comorbidities (OR 3.21, 95% CI 2.06-5.00, P < 0.001), age < 50 years (OR 3.85, 95% CI 2.41-6.14, P < 0.001), and the need for corticosteroids (OR 2.62, 95% CI 1.48-4.66, P = 0.001). Conclusion SD occurred frequently in the IBD population. Operation, depression, disease activity, comorbidities, age < 50 years, and the need for corticosteroids were risk factors for SD in IBD patients. SD screening might be recommended in IBD patients with the aforementioned factors.

关键词： Lycium ruthenicum Murray   Anthocyanins   Gut microbiota   Inflammatory bowel disease   Fermentation in vitro  

摘要： Anthocyanins from the fruits of Lycium ruthenicum Murray (ACN) can be degraded by gut microbiota into metabolites and regulate the structure of gut microbiota. In order to investigate the prebiotic effect of ACN, the effects of ACN and its main monomer, petunidin 3-O-[rhamnopyranosyl-(trans-p-coumaroyl)]-5-O-[beta-D-glucopyranoside] (P3G), on gut microbiota of feces from healthy volunteers and patients with inflammatory bowel disease (IBD) were investigated by fermentation in vitro in the present study. As results, it was found that the gut microbiota of IBD feces was disordered compared with healthy feces. ACN and P3G both could regulate the gut microbiota of healthy and IBD feces, including increasing the relative abundance of Lactobacillus and Bifidobacterium, and decreasing the relative abundance of Escherichia/Shigella. While the positive effect of ACN was better than that of P3G in IBD fecal fermentation. What's more, the production of acetic, propionic and lactic acids was promoted by ACN and P3G in healthy fecal fermentation and only lactic acid was promoted by both ACN and P3G in IBD fecal fermentation. In short, they showed a similar effect to prebiotics on gut microbiota, and provided important theoretical support for the development of the fruits of L. ruthenicum as functional food ingredients.

关键词： canine   gastroenterology   imaging   intestine   ultrasound  

摘要： Background Contrast-enhanced ultrasonography (CEUS) is used to evaluate vascularity of the gastrointestinal wall in neoplastic and inflammatory diseases. Objective To assess the feasibility of CEUS for the evaluation of duodenal perfusion in dogs with inflammatory bowel disease (IBD). Animals Forty-two dogs with IBD and 20 clinically healthy dogs. Methods All CEUS studies of the duodenum were analyzed to obtain time-intensity curves and perfusion parameters. The procedure was repeated in 12 IBD dogs 2 months after a standardized treatment. Results On CEUS, the duodenal wall showed a typical perfusion pattern characterized by a radial and simultaneous enhancement of the wall in all dogs. On qualitative assessment, no differences were observed in contrast medium distribution between healthy and affected dogs, or between dogs with IBD before and after treatment. Peak intensity (PI) and area under the curve (AUC) significantly differed between healthy (PI = 3.58 arbitrary units [au;1.86-4.93 au] and AUC = 47.63 au seconds [aus, 22.68-62.15]) and affected dogs (PI = 5.10 au [0.63-15.16 au] and AUC = 63.62 aus [5.31-212.20 aus];P = .03 and .03, respectively). No significant differences were found for the perfusion parameters before and after treatment. Conclusions and Clinical Importance We showed that CEUS allows discrimination between IBD affected dogs and healthy dogs by evaluation of time-intensity curves, but did not provide useful information for monitoring therapeutic response. The qualitative assessment identified no significant differences between healthy and affected dogs, or between dogs before and after treatment.

关键词： Inflammatory bowel disease   Zinc   Selenium   Inflammation   Trace elements  

摘要： Inflammatory bowel disease (IBD) is a chronic inflammatory condition that may emerge at a young age and often lasts for life. It often goes through phases of recurrence and remission and has a devastating effect on quality of life. The exact etiology of the disease is still unclear, but it appears that an inappropriate immune response to intestinal flora bacteria in people with a genetic predisposition may cause the disease. Managing inflammatory bowel disease is still a serious challenge. Oxidative stress and free radicals appear to be involved in the pathogenesis of this disease, and a number of studies have suggested the use of antioxidants as a therapeutic approach. The antioxidant and anti-inflammatory properties of some trace elements have led some of the research to focus on studying these trace elements in inflammatory bowel disease. Zinc and selenium are among the most important trace elements that have significant anti-inflammatory and antioxidant properties. Some studies have shown the importance of these trace elements in inflammatory bowel disease. In this review, we have attempted to provide a comprehensive overview of the findings of these studies and to gather current knowledge about the association of these trace elements with the inflammatory process and inflammatory bowel disease.

关键词： Monitoring   Biomarker   Preferences  

摘要： The original version of the article unfortunately contained an error in the acknowledgment content. The corrected acknowledgment with the UCSD Gastroenterology T32 training grant (DK 0,070,202) is given below.

关键词： NMR metabolomics   IBD stratification   IBD metabolomic profiling  

摘要： Inflammatory bowel disease is a multifactorial etiology, associated with environmental factors that can trigger both debut and relapses. A high level of tumor necrosis factor-alpha in the gut is the main consequence of immune system imbalance. The aim of treatment is to restore gut homeostasis. In this study, fresh blood and serum samples were used to identify biomarkers and to discriminate between Crohn's disease and ulcerative colitis patients under remission treated with anti-TNF. Metabolomics based on Nuclear Magnetic Resonance spectroscopy (NMR) was used to detect unique biomarkers for each class of patients. Blood T lymphocyte repertories were characterized, as well as cytokine and transcription factor profiling, to complement the metabolomics data. Higher levels of homoserine-methionine and isobutyrate were identified as biomarkers of Crohn's disease with ileocolic localization. For ulcerative colitis, lower levels of creatine-creatinine, proline, and tryptophan were found that reflect a deficit in the absorption of essential amino acids in the gut. T lymphocyte phenotyping and its functional profiling revealed that the overall inflammation was lower in Crohn's disease patients than in those with ulcerative colitis. These results demonstrated that NMR metabolomics could be introduced as a high-throughput evaluation method in routine clinical practice to stratify both types of patients related to their pathology. Key messages NMR metabolomics is a non-invasive tool that could be implemented in the normal clinical practice for IBD to assess beneficial effect of the treatment. NMR metabolomics is a useful tool for precision medicine, in order to sew a specific treatment to a specific group of patients. Finding predictors of response to IFX would be desirable to select patients affected by IBD. Immunological status of inflammations correlates with NMR metabolomics biomarkers.

摘要： T follicular helper (Tfh) cells represent a novel subset of CD4(+) T cells which can provide critical help for germinal center (GC) formation and antibody production. The Tfh cells are characterized by the expression of CXC chemokine receptor 5 (CXCR5), programmed death 1 (PD-1), inducible costimulatory molecule (ICOS), B cell lymphoma 6 (BCL-6), and the secretion of interleukin-21 (IL-21). Given the important role of Tfh cells in B cell activation and high-affinity antibody production, Tfh cells are involved in the pathogenesis of many human diseases. Inflammatory bowel disease (IBD) is a group of chronic inflammatory diseases characterized by symptoms such as diarrhea, abdominal pain, and weight loss. Ulcerative colitis (UC) and Crohn's disease (CD) are the most studied types of IBD. Dysregulated mucosal immune response plays an important role in the pathogenesis of IBD. In recent years, many studies have identified the critical role of Tfh cells and IL-21 in the pathogenic process IBD. In this paper, we will discuss the role of Tfh cells and IL-21 in IBD pathogenesis.

关键词： 中药熏洗   穴位敷贴   肛肠疾病   术后疼痛   安全性  

摘要： 探讨中药熏洗联合穴位敷贴治疗对肛肠疾病术后疼痛的效果和安全性。方法:60例肛肠疾病术后疼痛患者,随机分为观察组和对照组,各30例。对照组给予穴位敷贴治疗,观察组在对照组基础上联合中药熏洗治疗。比较两组治疗前后视觉模拟评分法(VAS)评分及换药后疼痛持续时间、创面愈合时间、临床疗效、不良反应发生情况。结果:术后第1天,观察组和对照组换药后疼痛持续时间分别为(3.26±0.72)、(3.14±0.69)h,两组比较差异无统计学意义(P>0.05);术后第3、5、7天,观察组换药后疼痛持续时间分别为(2.39±0.67)、(1.87±0.54)、(1.24±0.36)h均明显短于对照组的(2.87±0.59)、(2.31±0.61)、(1.72±0.43)h,差异有统计学意义(P<0.05)。观察组创面愈合时间为(13.06±4.26)d,短于对照组的(20.65±5.37)d,差异有统计学意义(P<0.05)。治疗前,两组VAS评分比较,差异无统计学意义(P>0.05);治疗后,观察组和对照组VAS评分分别为(3.83±0.86)、(4.57±0.98)分均显著低于治疗前的(7.63±1.22)、(7.54±1.06)分,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:对肛肠疾病术后疼痛患者进行中药熏洗联合穴位敷贴治疗可明显改善疼痛情况,提高治疗效果,疼痛持续时间明显缩短,加速创面愈合,并且具有较高安全性,具有临床推广应用价值。

关键词： 肛肠疾病   外科手术   抗菌药物   合理性  

摘要： 分析肛肠疾病外科手术后抗菌药应用状况及合理性。方法:回顾性分析2018年4月—10月入医院肛肠科手术治疗的157例患者临床资料,对比分析肛肠外科预防性使用抗菌药物疗程与术后切口感染、出血率关系。结果:157例患者在手术期均接受抗菌药物干预,预防抗菌药物使用率100.00%,使用品种合理率94.27% ,使用时机合理率98.73%,使用疗程合理率(≤48h)39.49%,其中63例为疗程≤48小时,术后切口感染发生率1.59%,术后切口出血发生率4.76%。疗程>48小时的手术例数94,术后切口感染发生率1.06%,术后切口出血发生率3.19%。经统计学分析,疗程≤48小时和疗程>48小时两组的术后切口感染率及术后切口出血发生率均无统计学差异(P>0.05)。结论:肛肠外科手术缩短预防抗菌药物使用疗程后,术后切口感染发生率、术后切口出血发生率均无明显上升。临床应加强肛肠外科患者围手术期抗菌药物使用情况的管理,严格控制预防性使用抗菌药物疗程,进一步降低抗菌药物使用强度,从而减缓细菌耐药的进程。